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Our understanding of climate dynamics during millennial-scale events is incomplete, partially due to the lack of their precise phase analyses under various boundary conditions. Here we present nine speleothem oxygen-isotope records from mid-to-low-latitude monsoon regimes with sub-centennial age precision and multi-annual resolution, spanning the Heinrich Stadial 2 (HS2) - a millennial-scale event that occurred at the Last Glacial Maximum. Our data suggests that the Greenland and Antarctic ice-core chronologies require +320- and +400-year adjustments, respectively, supported by extant volcanic evidence and radiocarbon ages. Our chronological framework shows a synchronous HS2 onset globally. Our records precisely characterize a centennial-scale abrupt "tropical atmospheric seesaw" superimposed on the conventional "bipolar seesaw" at the beginning of HS2, implying a unique response/feedback from low-latitude hydroclimate. Together with our observation of an early South American monsoon shift at the HS2 termination, we suggest a more active role of low-latitude hydroclimate dynamics underlying millennial events than previously thought.

Even as more companies integrate artificial intelligence (AI) into their new products and services, little research outlines the strategic implications of such AI adoption. Therefore, the present study investigates how investors respond to announcements of new product innovations integrated with AI by non-software firms (AI-NPIs), with the prediction that they respond favorably if the firms feature a marketing department with substantial power; such firms likely possess the marketing resources and assets needed to ensure the success of AI-NPIs. An event study with a sample of 341 announcements by 77 S&P 500 firms between 2009-2018 supports this prediction. Furthermore, the relationship between marketing department power and investor response intensifies when the announcement (1) occurs in later innovation stages, (2) involves the sourcing of external innovation assets, and (3) refers to more complex innovations. These findings have both theoretical and managerial implications., Author(s): Manjunath Padigar [sup.1] , Ljubomir Pupovac [sup.2] , Ashish Sinha [sup.3] , Rajendra Srivastava [sup.4] Author Affiliations: (1) grid.4830.f, 0000 0004 0407 1981, Faculty of Economics and Business, University [...]

Background: The National Health Policy 2017 has envisioned the integration of Health and Wellness Centers (HWCs) into India’s healthcare system as part of Ayushman Bharat. In February 2018, the Indian Government declared the transformation of 1,50,000 existing Sub Health Centers and Primary Health Centers into Health and Wellness Centers (HWCs) to provide Comprehensive Primary Health Care (CPHC). Health and Wellness Centres have an important role in the prevention of several diseases and health promotion and in undertaking public health functions in the community to strengthen the frontline workers and community platforms. Objective: To assess the availability of Infrastructure and 12 comprehensive primary health care services in study centres (HWC-SHC) in Raipur district Methodology: This is a cross-sectional observational study conducted in the 32 Health and wellness centre-sub centres of Raipur district, Chhattisgarh. In the Raipur district, there are 4 blocks and from each block, 25% of the study centres (HWC-SHC) are selected by simple random sampling. Semi- structured assessment tool with the reference of Government of India Operational Guidelines was used which consisted of checklist regarding Physical Infrastructure, Human Resource, Medicine, Diagnostic, IT component and 12 comprehensive primary health care services. The data was collected and analysis is being done by using SPSS software. Results: Out of 32 HWC-SHCs, 6 (18.75% ) were catering the services for the population as per the norms i.e. 3000- 5000. In the present study, 19 (59.4%) boundary wall, and 21 (65.6%) of SCs had wellness space. There were 31 (96.9%) of SCs had labor room, and 14 (43.8 %) had newborn care corner (NBCC). In this study, 21.9% Grievance board and 100% of IEC were present at the studied subcentres. It was observed that 31(96.9%) SCs had water, 27 (84.4%) had electricity supply and 1 (3.1%) of SCs had power backup. Separate public utilities for males and females were available in 2(6.3%) of the study centres. Out of the study sub-centre, 28 (87.5%) residential facilities were available, out of which 24 (85%) were occupied. For diagnostic services, 53.1 % of study centres have sickle- cell rapid tests and none of the centres have VIA for Screening of cervical cancer. Conclusion: The finding of the study shows that there is a scarcity in the physical infrastructure, Human resource and lab-diagnostic services at the studied centres. The major factor contributing to the non-utilization of health services at the SCs was the lack of adequate infrastructure, and logistics available at these centres.

Dentine adhesives have demonstrated great success with permanent teeth. Though the results in primary teeth are not well documented, some studies have demonstrated lower values of bond strength in primary teeth than those found in permanent teeth. The aim of this study was to compare and evaluate the effect of grape seed extract (6.5%) (Herbal Bio Solutions, Delhi, India), glutaraldehyde (5%) (Loba Chemie PVT. LTD., Mumbai), hesperidin (0.5%) (Herbal Bio Solutions, Delhi, India), and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) (GC Corporation, Alsip, IL, USA) on the shear bond strength of dentine of primary teeth and to evaluate the resin tags at the resin tooth interface. Seventy-five caries-free human primary molars were collected, and their occlusal surfaces were ground flat. Dentin surfaces were etched using phosphoric acid. Then teeth were randomly assigned in sequential order to five groups according to the dentinal treatment method: Group I (Control group) (no treatment), Group II (5% glutaraldehyde), Group III (6.5% grape seed extract), Group IV (0.5% hesperidin), and Group V (CPP-ACP). Ten teeth from each group were assigned for Shear Bond Strength and five for SEM analysis. ANOVA and a post hoc least significant difference test (p < 0.05) were used for statistical analysis of the collected data. The grape seed extract group showed significantly increased shear bond strength than the control group (p < 0.05), and the mean length of resin tags in different dentine bio modifiers groups was also statistically significant (p < 0.05). The use of dentin bio modifiers such as 5% glutaraldehyde, 6.5% grape seed extract, 0.5% hesperidin, and CPP-ACP in the bonding process for primary teeth did not improve the dentinal bond strength.

The Younger Dryas (YD), arguably the most widely studied millennial-scale extreme climate event, was characterized by diverse hydroclimate shifts globally and severe cooling at high northern latitudes that abruptly punctuated the warming trend from the last glacial to the present interglacial. To date, a precise understanding of its trigger, propagation, and termination remains elusive. Here, we present speleothem oxygen-isotope data that, in concert with other proxy records, allow us to quantify the timing of the YD onset and termination at an unprecedented subcentennial temporal precision across the North Atlantic, Asian Monsoon-Westerlies, and South American Monsoon regions. Our analysis suggests that the onsets of YD in the North Atlantic (12,870 ± 30 B.P.) and the Asian Monsoon-Westerlies region are essentially synchronous within a few decades and lead the onset in Antarctica, implying a north-to-south climate signal propagation via both atmospheric (decadal-time scale) and oceanic (centennial-time scale) processes, similar to the Dansgaard-Oeschger events during the last glacial period. In contrast, the YD termination may have started first in Antarctica at ∼11,900 B.P., or perhaps even earlier in the western tropical Pacific, followed by the North Atlantic between ∼11,700 ± 40 and 11,610 ± 40 B.P. These observations suggest that the initial YD termination might have originated in the Southern Hemisphere and/or the tropical Pacific, indicating a Southern Hemisphere/tropics to North Atlantic-Asian Monsoon-Westerlies directionality of climatic recovery.

Tufa deposits have significant potential for reconstructing past lake-level fluctuations. Here, we conducted U-Th dating of tufa deposits exposed along the shoreline of Longmu Co Lake in the northwestern Tibetan Plateau to reconstruct its water level history during the middle-late Holocene. Our data demonstrate that Longmu Co Lake reached its highest level (61 m above the present level) at around 7.4 ka in response to the strengthened Indian Summer Monsoon and increased glacial meltwater; its lake level subsequently decreased due to solar insolation-induced decline in summer monsoon and glacial meltwater. Moreover, we find that the lake level experienced an abrupt decline at ~2.2 ka with a maximum amplitude of 13 m, probably owing to the rapid cooling of the local climate. The δ18O and δ13C of Longmu Co tufa also show a covariance trend, which supports the regional climate change reflected by the lake level fluctuation of Longmu Co. Additionally, we observed an inverse correlation between initial δ234U content in tufa and lake level variation, suggesting that initial calcium δ234U can serve as a proxy for reconstructing environmental changes. Our study therefore implies that lake tufa as a reliable archive for accurately reconstructing lake level changes. [ABSTRACT FROM AUTHOR]

Identifying tropical cyclone (TC) signatures in paleoclimate records enhances our understanding of long-term TC activity trends and the climatic factors influencing TC evolution. Stalagmites are considered promising archives for recording TC activity. However, despite the western North Pacific being the most TC-active ocean basin globally, it lacks stalagmite-based TC reconstructions. Here, we present a seasonally resolved stalagmite δ18O record from XRY cave in Southeast China, covering the period from 1951 to 2018 CE, to identify annual signals of strong TC activity. We propose that the minimum seasonal XRY δ18O value of each year can reconstruct regional TC activity, achieving an identification rate of 86% for strong TC years in study area. This demonstrates the feasibility of using stalagmites for TC reconstruction in Southeast China. Moreover, our research shows that inland stalagmites can still capture TC activity signals, which will promote the use of stalagmites in obtaining long-term records of post-landfall TC activity and inland impacts. [ABSTRACT FROM AUTHOR]

The 8.2 ka event has been extensively investigated as a remarkable single event but rarely considered as a part of multi-centennial climatic evolution. Here, we present absolutely dated speleothem multi-proxy records spanning 9.0–7.9 ka from Beijing in North China, near the northern limit of the East Asian summer monsoon (EASM) and thus sensitive to climate change, to provide evidence of the intensified multi-decadal climatic oscillations since 8.52 ka. Three extreme excursions characterized by inter-decadal consecutive δ18 O excursions exceeding ±1σ are identified from 8.52 ka in our speleothem record. The earlier two are characterized by enriched 18 O at ∼8.50 and 8.20 ka, respectively, suggesting a prolonged arid event, which is supported by the positive trend in δ13 C values, increased trace element ratios, and lower growth rate. Following the 8.2 ka event, an excessive rebound immediately emerges in our δ18 O and trace element records but moderate in the δ13 C, probably suggesting pluvial conditions and nonlinear response of the local ecosystem. Following two similar severe droughts at 8.50 and 8.20 ka, the different behavior of δ13 C suggests the recovering degree of resilient ecosystem responding to different rebounded rainfall intensity. A comparison with other high-resolution records suggests that the two droughts–one pluvial pattern between 8.52 and 8.0 ka is of global significance instead of being a regional phenomenon, and is causally linked to the slowdown and acceleration of the Atlantic Meridional Overturning Circulation that was further dominated by the freshwater injections in the North Atlantic. [ABSTRACT FROM AUTHOR]

Background: Undernutrition raises the likelihood of progressing from tuberculosis (TB) infection to active TB illness and causes weight loss. Proper food and nutrition are important in the treatment of tuberculosis patients. Active tuberculosis necessitates a substantial energy expenditure. The Tuberculosis treatment guidelines neglect the nutritional supplementation part of Tuberculosis management. The study aims to determine the factors affecting the nutritional status of pulmonary Tuberculosis patients. Material and Methods: A hospital‑based cross‑sectional study was conducted from December 2021 to January 2022 among the patients newly diagnosed and above 18 years of age coming to DOTS Centre (DMC) of Pt J.N.M. Medical College, Raipur. Total 120 subjects were selected by consecutive sampling method. Data was analyzed using SPSS version 24, and P value <0.05 was considered statistically significant. Result: Among 120 study subjects, malnourished was 54.16% (BMI <18.50 kg/m²), normal was 35% (BMI 18.50–24.99 kg/m²), overweight was 6.67% (BMI 25–29.99 kg/m²), and obese were 4.17% (BMI 30–34.99 kg/m²). Among 120 study subjects, the maximum number of them (96.3%) had a dietary gap in their diets which was equal in two groups of 1–50% calorie deficit and 51–100% calorie deficit. Conclusion: A high proportion of tuberculosis patients were undernourished, and even a very distal factor for undernutrition became proximal for tuberculosis patients. To control tuberculosis and to end the tuberculosis disease, an improvement in the nutritional status of the patient should be our priority. By knowing the importance of nutrition in TB patients, the primary care physicians can decrease the morbidity and mortality in TB patients. [ABSTRACT FROM AUTHOR]

Background: Sickle cell disease (SCD) is a disorder marked by a single‑point mutation in the beta‑globin gene. Hydroxyurea is a globally accepted disease‑modifying agent that sounds to be effective in managing clinically and probably preventing complications of SCD. The current study aims to document the morbidity pattern and impact of Hydroxyurea therapy in the Outpatient Department of Sickle Cell Institute, Raipur. Materials and Methods: This cross‑sectional study was conducted among randomly selected sixty‑five patients (adults and children above six years). After obtaining informed consent, relevant data were collected in a predesigned pretested questionnaire. The appropriate statistical exercise was applied for the interpretation of results and inferences. Results: Acute febrile illness 54 (83%) and 53 (81.5%) reported pain crisis observed to have the most common morbidity among the study subjects, followed by 55.4% (36), 33 (50.8%) jaundice and difficulty breathing, respectively. Joint pain was the most commonly observed complaint, particularly at the knee joint (76.9%). Other complaints such as hand‑foot syndrome (24.6%), epistaxis (27.7%), and acute chest syndrome (21.5%). Vaso‑occlusive crisis (72.4%), difficulty in walking (60.0%) and eyesight (35.4%), leg ulcers (9.2%), and dactylitis (3.1%) were also documented as clinical manifestations among study participants. Less than half (44.46%) had an awareness about SCD. Hydroxyurea therapy was highly significant in improving the patient’s clinical picture (P < 0.01), especially following the frequency of hospitalization and the requirement for blood transfusion. Conclusion: Pain crisis is the most common morbidity among study participants with a low level of knowledge about SCD with febrile illness. Hydroxyurea therapy was found to be quite effective as a disease‑modifying therapy, especially for reducing the frequency of blood transfusion and lowering hospitalization rates among SCD patients. [ABSTRACT FROM AUTHOR]

Central Asia (CA) is one of the world's most significant arid regions, which is markedly impacted by global warming. A better understanding of the dynamical processes governing its Holocene climate variability is critical for a better understanding of possible future impacts of climate change in the region. To date, most of the existing CA paleoclimate records are from the summer precipitation-dominated eastern CA (ECA), with few records from the winter precipitation-dominated western CA (WCA). Here, we present a precisely dated (~6‰) and highly resolved (<4-y) record of hydroclimatic variations from the WCA covering the period between 7,774 and 656 y BP. Utilizing multiple proxies (δ18O, δ13C, and Sr/Ca) derived from a stalagmite from the Fergana Valley, Kyrgyzstan, we reveal a long-term drying trend in WCA, which is in contrast with the wetting trend in ECA. We propose that different responses of winter and summer westerly jets to seasonal solar insolation over the past 8,000 y may have resulted in an antiphased precipitation relationship between the WCA and ECA. Our data contain dominant quasiperiodicities of 1,400, 50 to 70, and 20 to 30 y, indicating close connections between the WCA climate and the North Atlantic. We further identified a series of droughts and pluvials on centennial-to-decadal timescales, which may have influenced regional societies and trans-Eurasian culture exchanges during historical and prehistorical times. [ABSTRACT FROM AUTHOR]

This study aims to undertake the Participatory Livelihood Vulnerability Assessment (PLVA) of forest dwellers in the Jharkhand and Odisha states of eastern Indian region. The study covers 15 tribes that included 8 Particularly Vulnerable Tribal Groups (PVTGs) and 7 other tribes from eight districts of Jharkhand and Odisha. The authors combined both participatory and survey-based approaches and used the simple indexing method for PLVA. They observed that landless families were among the most vulnerable. The forest dwellers have poor access to education and health. Both minor forest produce and social-welfare measures are important safety nets for the forest dwellers. There is, however, better access to banking, pukka houses, toilets and so on. Furthermore, attention is required to strengthen livelihood opportunities for the forest dwelling communities. [ABSTRACT FROM AUTHOR]

Dentine adhesives have demonstrated great success with permanent teeth. Though the results in primary teeth are not well documented, some studies have demonstrated lower values of bond strength in primary teeth than those found in permanent teeth. The aim of this study was to compare and evaluate the effect of grape seed extract (6.5%) (Herbal Bio Solutions, Delhi, India), glutaraldehyde (5%) (Loba Chemie PVT. LTD., Mumbai), hesperidin (0.5%) (Herbal Bio Solutions, Delhi, India), and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) (GC Corporation, Alsip, IL, USA) on the shear bond strength of dentine of primary teeth and to evaluate the resin tags at the resin tooth interface. Seventy-five caries-free human primary molars were collected, and their occlusal surfaces were ground flat. Dentin surfaces were etched using phosphoric acid. Then teeth were randomly assigned in sequential order to five groups according to the dentinal treatment method: Group I (Control group) (no treatment), Group II (5% glutaraldehyde), Group III (6.5% grape seed extract), Group IV (0.5% hesperidin), and Group V (CPP-ACP). Ten teeth from each group were assigned for Shear Bond Strength and five for SEM analysis. ANOVA and a post hoc least significant difference test (p < 0.05) were used for statistical analysis of the collected data. The grape seed extract group showed significantly increased shear bond strength than the control group (p < 0.05), and the mean length of resin tags in different dentine bio modifiers groups was also statistically significant (p < 0.05). The use of dentin bio modifiers such as 5% glutaraldehyde, 6.5% grape seed extract, 0.5% hesperidin, and CPP-ACP in the bonding process for primary teeth did not improve the dentinal bond strength. [ABSTRACT FROM AUTHOR]

Precipitation in southwestern North America has exhibited significant natural variability over the past few thousand years. This variability has been attributed to sea surface temperature regimes in the Pacific and Atlantic oceans, and to the attendant shifts in atmospheric circulation patterns. In particular, decadal variability in the North Pacific has influenced precipitation in this region during the twentieth century, but links to earlier droughts and pluvials are unclear. Here we assess these links using δ 18 O data from a speleothem from southern California that spans AD 854-2007. We show that variations in the oxygen isotopes of the speleothem correlate to sea surface temperatures in the Kuroshio Extension region of the North Pacific, which affect the atmospheric trajectory and isotopic composition of moisture reaching the study site. Interpreting our speleothem data as a record of sea surface temperatures in the Kuroshio Extension, we find a strong 22-year periodicity, suggesting a persistent solar influence on North Pacific decadal variability. A comparison with tree-ring records of precipitation during the past millennium shows that some droughts occurred during periods of warmth in the Kuroshio Extension, similar to the instrumental record. However, other droughts did not and instead must have been influenced by other factors. Finally, we find a significant increase in sea surface temperature variability over the past 150 years, which may reflect an influence of greenhouse gas concentrations on variability in the North Pacific.